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European Journal of Echocardiography 2005 6(6):465-469; doi:10.1016/j.euje.2005.08.002
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Copyright © 2005, The European Society of Cardiology

Late cardiac tamponade after percutaneous closure of a patent foramen ovale

Thomas Christena, François Macha, Dominique Didierb, Afksendyios Kalangosc, Vitali Verina and Pedro T. Trindadea,*

aDivision of Cardiology, University Hospital, Geneva, Switzerland
bDivision of Radiology, University Hospital, Geneva, Switzerland
cDivision of Cardiovascular Surgery, University Hospital, Geneva, Switzerland

Received 30 March 2005; received in revised form 25 July 2005; accepted after revision 3 August 2005.

pedro.trigo-trindade{at}hcuge.ch

* Corresponding author. Division of Cardiology, Geneva University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. Tel.: +41 22 372 71 95; fax: +41 22 372 72 29.


  Abstract

We report the case of a 35-year-old man who had a transient ischemic cerebral attack and then underwent a percutaneous closure of the patent foramen ovale (PFO) with a Cardiastar device. One year later, the patient developed a cardiac tamponade due to an important hemorrhagic pericardial effusion. Transoesophageal echocardiography showed that one of the struts had impinged on the aortic root in the region adjacent to the transverse pericardial sinus. Therefore, we speculated that the strut had passed through the aortic wall by slow erosion, leading to the pericardial effusion. Cardiac CT and subsequent surgery confirmed the perforation of the left atrial roof and the aortic root by two struts of the device. This is the first reported case of late cardiac tamponade and underscores the importance of long-term follow-up after PFO closure device implantation.

Keywords: Atrial septal abnormality; Percutaneous PFO closure; Cryptogenic stroke; Pericardial effusion; Late complication; Intracardiac device


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